肾脏病理类型对糖尿病肾病患者生存状况的影响

Relationship between pathological types and prognosis in diabetic nephropathy

摘要:

目的  探讨肾脏病理类型对糖尿病肾病患者生存状况的影响，为其临床研究提供可参考依据。方法  共纳入80例海南医学院附属医院诊断为糖尿病肾病的患者作为观察对象，所有患者均行肾组织病理检查，并根据其病理类型分为结节组和弥漫组，比较其临床特征差异，并分析不同病理类型的生存状况。结果  结节组患者糖尿病病程、空腹血糖、糖化血红蛋白及视网膜病变均明显高于弥漫组患者，差异有统计学意义（P < 0.05）；而弥漫组患者白蛋白水平高于结节组患者，差异有统计学意义（P <0.05）。结节组患者尿β2-MG、尿mAlb均明显高于弥漫组患者，差异有统计学意义（P <0.05）；而弥漫组患者GFR高于结节组患者，差异有统计学意义（P <0.05）。随访2年，结节组患者存活率57.1%明显低于弥漫组81.6%，差异有统计学意义（P <0.05）。结论  糖尿病肾病结节性病变与弥漫性病变临床特征与预后有明显差异，结节性病变病程更长，肾脏损失更为严重，更容易并发视网膜病变，且预后更差。

Abstract:

Objective To elucidate the relationship between pathological types and prognosis in diabetic nephropathy. Methods A total of 80 patients with diabetic nephropathy were included. All patients were performed renal tissue pathologic examination, and were divided into nodular group and diffuse group according to pathological types. The clinical characteristics were compared, and the conditions of different pathological types were analyzed. Results The duration, fasting glucose, glycosylated hemoglobin and retinopathy in nodular group were statistically higher than that in diffuse group (P < 0.05). The albumin levels in nodular group were statistically lower than that in diffuse group (P < 0.05). The urinary β2-MG, urinary mAlb in nodular group were higher than that in diffuse group (P < 0.05). The GFR in nodular group were lower than that in diffuse group, and the difference was statistically significant (P < 0.05). The survival rate in nodular group was 57.1%, which was higher than 81.6% in diffuse group (P < 0.05). Conclusions Diabetic patients with nodular glomerulopathy have longer clinical courses, more severe kidney damage, more chances to complicated with retinopathy, and poorer prognosis.